=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306047022
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARLA MICHELLE ONEAL NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2007
-----------------------------------------------------
Last Update Date | 09/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 445 E DUBLIN GRANVILLE RD
-----------------------------------------------------
City | WORTHINGTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43085-3192
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-773-0650
-----------------------------------------------------
Fax | 216-773-0650
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4539 RISHEL ST
-----------------------------------------------------
City | GROVE CITY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43123-7682
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-773-0650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN. 295742
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WH0200X
-----------------------------------------------------
Taxonomy Name | Home Health Registered Nurse
-----------------------------------------------------
License Number | RN. 295742
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | NP-09897
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------